After reading the article you will get answers to the questions below
IS LASER THE BEST TREATMENT FOR PILES AND FISTULA?
CAN ALL TYPES OF FISTULA AND PILES BE TREATED BY LASER ALONE?
DOES LASER GIVE THE BEST RESULTS ALWAYS IN ALL TYPES OF CASES?
IS THE CHANCE OF RECURRENCE LESS OR MORE WITH LASER TREATMENT AS COMPARED TO OTHER TREATMENT MODALITIES?
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In the last few years, Laser treatment for piles and especially for fistulas has got a lot of attention from surgeons as well as patients.
For a lot of people, it has become synonymous with a quick, painless, cutless surgery with no follow-up required. Eureka !! isn't that perfect? It indeed sounds perfect. For a centuries-old problem which till now had no perfect answers, suddenly the laser fiber (a fiber used in the laser treatment) has appeared as an "AVATAR" straight from Lord Dhanvantri's armamentarium.
One of the reasons seems to be the incessant digital marketing of these techniques. The word LASER is thrown in by companies promoting it so indiscriminately that patients are now made to believe that this is the only perfect treatment. it's then not surprising when patients ask " Sir, treatment LASER se he hoga na ?". Even if a competent surgeon tries to explain the pros and cons of it to a patient, then they are inclined to think that they have come to the wrong place. That the surgeon probably will offer some other treatment or is not well versed with LASER treatment.
Before I proceed further, I want to tell everyone that I am all for LASER PROCTOLGY. I have nothing against it. I use it frequently myself for my patients. In fact, I don't just use it, but I love it. I love it for what it can do. But at the same time, I, like all truthful surgeons take things with a pinch of salt and acknowledge the limitations of this modality of treatment.
Usually, any new surgical modality, let's say laparoscopy (keyhole surgery) takes some time before it became the standard of care for many procedures. Initially, laparoscopy was suited only for easier cases. But as the expertise and technology improved, the range of surgeries that are now routinely done with laparoscopy has increased. Laser for proctology has not followed this trend. It has risen to popularity comparatively briskly. Some of the reasons for this are, the commercial promotion, ease to learn by surgeons, the surgeries that it is used for are minor day-care procedures and the procedures are not life-threatening nor require prolonged hospitalization.
But laser also has its disadvantages. Firstly, and importantly the recurrence rate (risk for fistula coming back) with laser is higher as compared to a correctly performed conventional surgery. The recurrence of the fistula is the most distressing thing for the surgeon and patient alike. The probability of recurrence of a fistula differs from case to case. Some other factors that a surgeon might consider before deciding which surgery to choose are the complexity of the fistula, any prior surgery, the patient's age, gender, etc. That means that treatment for every patient has to be tailor-made. So as a patient, beware not to have preconceived notions that this and only this is the best option for you. A company interested in its return on investment or increasing its number of patients may not tell you this. It will offer whatever is most pleasing to the patient and care least for the result. But a surgeon of repute will tell you all this and discuss your case on an individual basis.
In the end, just to summarize I will say that the LASER is here to stay. There should be no doubt about it. And why not, when it can reduce the misery of the patient in so many ways? But, to deem it as the end all and be all will be incorrect.
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